"A federal appeals court ruled unanimously Thursday that the Defense of Marriage Act, passed by Congress in 1996, discriminates against married same-sex couples by denying them the same federal benefits afforded to heterosexual couples.

"The decision will have no immediate effect because it anticipates an appeal to the United States Supreme Court.

"In upholding an earlier decision by a lower court, Thursday’s ruling, by a three-judge panel of the First United States Circuit Court of Appeals in Boston, is the first time an appeals court has declared the federal law unconstitutional.

"The ruling dealt narrowly with the question of federal benefits for same-sex couples, not with the legality of same-sex marriage itself.
...
“Today’s landmark ruling makes clear once again that DOMA is a discriminatory law for which there is no justification,” Martha Coakley, attorney general of Massachusetts, said in a statement. It was under Ms. Coakley’s direction that Massachusetts became the first state, in 2009, to complain formally that DOMA was unconstitutional.

"A federal judge in Massachusetts found in 2010 that the law violated the equal protection clause of the constitution by denying benefits to one class of married couples — gay men and lesbians — but not to others.

"The appeals court on Thursday agreed, saying the law interfered with the right of a state to define marriage. The benefits denied to same-sex couples range from the right to file joint tax returns, which can reduce a couple’s payments, to the ability to collect death benefits.

"While both sides wait to see whether the Supreme Court takes the case — Ms. Bonauto said that every expert she had talked to predicted it would — the ruling will not be enforced, meaning that same-sex couples cannot begin to collect federal benefits.

"The first circuit covers Maine, Massachusetts, New Hampshire, Rhode Island and Puerto Rico.

"Since DOMA was passed, eight states and the District of Columbia have approved same-sex marriage; the states are Connecticut, Iowa, Maryland, Massachusetts, New Hampshire, New York, Vermont and Washington. Maryland and Washington's laws are not yet in effect.

"President Obama campaigned against the law in 2008 and said in 2011 that his administration would not defend it. That has left the Bipartisan Legal Advisory Group, appointed by the Republican majority in the House, to defend the case. The group has said that Congress wanted to preserve DOMA because it provided a traditional and uniform definition of marriage, helping the federal government to distribute federal benefits."
**************

"A bill pending before the State Senate would prohibit public universities
from "contracting with outside search firms, executive search firms, or similar
organizations." Supporters of the legislation say that paying consultants to
find candidates is a poor use of taxpayer and tuition dollars, and that hiring
is a responsibility that should fall to those on the university's payroll.
...
"Universities across the country have increasingly turned to outside
consultants, at least for hiring at the presidential level. Search consultants
were used to recruit nearly 60 percent of recently hired presidents, a jump from
49 percent four years ago, according to an American Council on Education survey
released this year.
**************

"Illinois legislators have approved a bill that would restrict the use of
search firms to fill vacancies at public universities, but the measure backs
away from earlier proposals that would have banned the increasingly popular
practice entirely.

"The amended bill, which passed the Illinois House of Representatives and the
State Senate this week, would allow universities to contract with search firms
to help fill presidential vacancies, but it would limit their use in other
cases. Before employing outside consultants to aid in nonpresidential searches,
a university and its board of trustees would have to "demonstrate a justifiable
need for guidance from an individual or firm with specific expertise in the
field of the hiring." The bill would require the state's public institutions to
enact policies that define the criteria for when hiring a search firm is
necessary.

"The bill, HB 5914, will next be sent to the governor, who is reviewing the
legislation, his spokesperson said Wednesday.

"The University of Illinois objected to earlier
versions of the bill that featured a complete ban on outside search
consultants, arguing that such a prohibition would impede its ability to compete
for well-qualified candidates. Over the past several months, the university has
sought to persuade the legislation's sponsors to relax the language in the
bill."

"Most patients assume that if they've got an ailment their family doctor can't fix, they'll be referred to a specialist who's, well, special for reasons they expect: ... So it may come as a surprise that the nattily dressed guy or gal sitting two chairs down in the waiting room, the one who brought that jumbo tin of caramel popcorn for the front-desk staff, may play a role in determining the next surgeon they see.

"With specialists' operating margins having fallen in the past decade and health care reforms putting increasing pressure on their bottom line, more are turning to this burgeoning group of marketing pros to open new-patient pipelines. For anywhere from $3,000 to $10,000 a month, these so-called referral-development consultants will provide marketing plans and dispatch a "physician liaison" to pound the pavement and praise the doctors' prowess. The pitches can focus as much on waiting-room decor as on clinical credentials, but in the end, marketers say, they're sparing doctors the roadside-billboard approach to bringing in patients, and reshaping a long-ignored, but important component of doctoring. "I tell doctors how to sell their business without looking needy, cheesy, greedy or sleazy," says Stewart Gandolf, founding partner of Healthcare Success Strategies, a Southern California medical marketing firm, which says it helped double referrals for one Midwest ophthalmologist in a six-month period.

"But while no one can fault a doctor for trying to drum up business in tough times, critics say that medicine and marketing can make for strange bedfellows. To be sure, accepting payment for a referral is illegal and patient advocates say that no doctor will intentionally make a bad referral....[But] a steady stream of thank-you gifts might keep a specialist top-of-mind. (Even years later, the Mobile, Ala., dental community still raves about one oral surgeon's gift basket: ribs and bottles of Jack Daniels.)

...

"The American Medical Association's Code of Medical Ethics requires doctors to provide patients with "relevant information" about potential procedures, but has no guidelines on what to tell them about the specialist to whom they're being sent. "It goes against the basic trust that is the centerpiece of the physician patient relationship," says Peter Clark, director of the Institute of Catholic Bioethics

...

"If doctors are just getting in on the referral game, hospitals have been at it for some time -- and on a larger scale. Whereas patients see a hospital only as a place for serious tests and procedures, administrators see a hospital also as a collection of business areas (radiology, ORs, cancer centers) with specific revenue targets -- goals most readily reached when providers send along more patients. When hospitals buy physician practices and become their bosses, federal law prevents them from tying doctors' compensation to in-house referrals. But they are allowed to incentivize them by offering bonuses based on the overall performance of the hospital. "Go into a hospital board room, and 99 percent of the time they're talking about referrals and physician relations," says Timothy Crowley, a former managing director at Leerink Swann, a health care investment bank.

"Indeed, at a recent Hospital and Physician Relations Summit in Scottsdale, Ariz., hospital administrators and doctors gathered for three days to collectively fret about everything from "physician alignment" to "referral leakage." In one session, a Pennsylvania hospital official identifies one type of leak -- proactive patients doing their own doctor research -- as a growing challenge. Not that patients can't be corralled. Many hospitals now employ staffers called "navigators," who help recovering patients with paperwork and follow-up appointments. Part of their job, though, is insuring that the patients' next specialist has the same hospital logo on his or her lab coat.

AbstractIt has been previously shown that for sufficiently large pools of patient-donor pairs, (almost) efficient kidney exchange can be achieved by using at most 3-way cycles, i.e. by using cycles among no more than 3 patient-donor pairs. However, as kidney exchange has grown in practice, cycles among n > 3 pairs have proved useful, and long chains initiated by non-directed, altruistic donors have proven to be very effective.

We explore why this is the case, both empirically and theoretically. We provide an analytical model of exchange when there are many highly sensitized patients, and show that large cycles of exchange or long chains can significantly increase efficiency when the opportunities for exchange are sparse. As very large cycles of exchange cannot be used in practice, long non-simultaneous chains initiated by non-directed donors significantly increase efficiency in patient pools of the size and composition that presently exist. Most importantly, long chains benefit highly sensitized patients without harming low-sensitized patients.

By keeping markets in their place, we can avoid their corrosive effects.

Sandel lays out his views more fully than in the quote at the top of the page (if not always more clearly) in the lead essay of the forum: How Markets Crowd Out Morals, and in his reply to the commentators, some sympathetic and some less so. Bowles and Welch and Gintis all suggest that the level of the discussion could be raised by considering evidence, of various kinds.

How can we integrate public schools when neighborhoods have become more segregated? Is it time to bring back busing? What other options and solutions are out there for providing a quality education for all children?

Sunday, May 27, 2012

Adam Bingaman and his colleagues at the Methodist Specialty and Transplant Hospital, in San Antonio, Texas, report on their stellar experience with kidney exchange (kidney paired donation). One key to their success is that they enroll compatible as well as incompatible pairs.

Abstract: Many potential kidney transplant recipients are unable to receive a live
donor transplant due to crossmatch or blood type incompatibility. Kidney paired
donation increases access to live donor transplantation but has been
significantly underutilized. We established a kidney paired donation program
including consented incompatible donor/recipient pairs as well as compatible
pairs with older non-human leukocyte antigen identical donors. Over a 3-year
period, a total of 134 paired donor transplants were performed, including 117
incompatible pairs and 17 compatible pairs. All transplants were done with
negative flow cytometry crossmatches and five were done with desensitization
combined with paired donation. Kidney paired donation transplants included
two-way and three-way exchanges as well as three chains initiated by nondirected
donors. Of the sensitized recipients transplanted by paired donation, 44% had
calculated panel reactive antibody levels greater than 80%. Transplantation of
females and prior transplant recipients was significantly higher with paired
donation. Only three episodes of rejection occurred and no transplants were lost
due to rejection. These data highlight the potential of kidney paired donation
and suggest that all transplant centers should be actively engaged in paired
donation to increase access to live donor transplantation.

"MaritalAffair.co.uk, one of the largest sites of its kind, has almost 600,000 members. Analysis shows most members are parents aged 35 to 54, university educated, and browse from their own homes. Women using the site on a weekly basis outnumber the site three to one.
"Ashley Madison, a US-based website specialising in “discreet affairs” said it received a new British member every 45 seconds. More than 150,000 Britons use the site each week."

The article briefly mentions the work that Itai Ashlagi and I are doing to help optimize long chains, which have the potential to increase not only the number of transplants, but the number of transplants received by the most highly sensitized patients. (More on this soon...)

Thursday, May 24, 2012

"In the first year of Harvard’s renewed early admissions program, the yield for the class of 2016 soared to nearly 81 percent, a significant increase from last year’s rate of 77 percent, the University announced on Thursday.

...

In December, Harvard admitted 772 students under its early action program. Another 1,260 acceptances were extended in March. Overall, 1,641 of those admitted to the Class of 2016 accepted their offer of admission from Harvard.

Due to this high yield a very small number of students will be taken off the waitlist, approximately 25, Fitzsimmons said. The admissions office began reviewing waitlisted applications on Thursday, he added.

************

Congratulations to the class of 2016, and congratulations to the class of 2012, who graduate today.

Attaining modest levels of revenue can be raised with a straight percentage charge and switching to value-added pricing for greater levels of revenue.

Economic analysis is an imperfect guide to the design of markets. Consequently, new designs should be tested in a laboratory setting prior to use in the world. Moreover, an understanding of what participants actually value is critical to a successful design."

Tuesday, May 22, 2012

"Federal law bans payments for organs. But given the need, we wondered what
Americans thought about compensation for three kinds of donations that can be
made while people are alive: kidneys, bone marrow and a portion of liver big
enough to help someone whose liver is failing.

"So we asked 3,000 adults across the country as part of the NPR-Thomson
Reuters Health Poll, and here's what they told us.
"If compensation took the form of credits for health care needs, about 60
percent of Americans would support it. Tax credits and tuition reimbursement
were viewed favorably by 46 percent and 42 percent, respectively. Cash for
organs was seen as OK by 41 percent of respondents.

"Among people who said some form of compensation was acceptable, 72 percent
said it should come from health insurers, followed by private charities at 62
percent and the federal government at 44 percent.
"For all forms of compensation, rates of support tended to fall among older
respondents.

"There's been longstanding resistance to compensating donors financially in
this country. There are concerns about exploitation and also worries that even
small amounts of compensation would undercut a system that depends on
altruism."

Monday, May 21, 2012

Are too many things available to buy? That seems to be a theme of much recent literature that, at its worst, regrets how the economy has sucked the meaning out of life ever since the invention of trade and agriculture. The idea is that economic life weakens the close bonds with kin and community we used to build while we helped each other ward off starvation.

Markets are not the only focus of that concern: the expansion of cities and the encroachment of technology are others. For technology, think of the internet and social media, but don't forget the earlier effects of the automobile and the phonograph. As for what you can buy these days with money, and the growth of markets, don't forget bottle feeding and washing machines, and women in the labor force.

But even if we have no nostalgia for the bad old days, it doesn't hurt to be aware of how the increasing scope of markets, like the growth of cities and technology, changes how we relate to one another.

In a recent NY Times Op Ed, the sociologist Arlie Russell Hochschild, who teaches at Berkeley, writes of her concerns about the increased reach of markets, The Outsourced Life. The article is accompanied by pictures of ads for all sorts of services that can now be bought and sold, from birthday party planners to cooking coaches, to upgraded accommodations in a private prison, to someone offering a service called "rent a dad."

I recently received a review copy (one of the few signs that the world notices a blog).

It is a thoughtful book, on a topic in which I have a professional interest, but I wasn't encouraged when it began by regretting the loss of small town community that the author experienced as a child visiting her grandmother's farm. She visited from the city, a life her parents had chosen, and which she later chose herself. But the book is saved from nostalgia for the lost world by the acknowledgement of how much easier it would have been to take care of her elderly grandmother, years later when she was frail, if only she had lived near a city and the services that money could buy, and which a granddaughter could not easily deliver from far away.

So, and here is the interesting part of this kind of discussion, the loss of community isn't just something that happens because people choose to move to cities for the better opportunities and bigger markets they offer (even though they may regret, at least in memory, leaving the town behind). Loss of community is also something that happens to those left behind, as the towns are thinned out by those who moved on, so less community remains. Professor Hochschild and her parents chose to move away from the farm, and didn't ever really want to go back, but there's no going back even if they did want to: that old community isn't there anymore.

Of course, some of it was never really there. The book compares her grandfather's courtship of two sisters, one of whom became her grandmother and the other who apparently made a poor marriage (to "a n'er-do-well farmer"), with today's internet dating. Internet dating also doesn't always work out, it seems. Her grandmother did better with the old fashioned process, but it wasn't so great for her great-aunt.
**********

Sandel turns out to be a childhood friend of NY Times columnist Thomas Friedman, who writes about Sandel's book in a May 12 column called This Column Is Not Sponsored by Anyone
"
Seen in isolation, these commercial encroachments seem innocuous enough. But Sandel sees them as signs of a bad trend: “Over the last three decades,” he states, “we have drifted from having a market economy to becoming a market society. A market economy is a tool — a valuable and effective tool — for organizing productive activity. But a ‘market society’ is a place where everything is up for sale. It is a way of life where market values govern every sphere of life.”

"Why worry about this trend? Because, Sandel argues, market values are crowding out civic practices. When public schools are plastered with commercial advertising, they teach students to be consumers rather than citizens. When we outsource war to private military contractors, and when we have separate, shorter lines for airport security for those who can afford them, the result is that the affluent and those of modest means live increasingly separate lives, and the class-mixing institutions and public spaces that forge a sense of common experience and shared citizenship get eroded."
***********

INTRODUCTION

Jim Wilson/The New York TimesProstitutes wait for customers at a legal brothel in Nevada.

Some say laws against prostitution unfairly victimize women. A Canadian court recently ruled that laws preventing brothels endangered prostitutes by forcing them to work on the streets. And as the recent Secret Service scandal makes clear, in Colombia, prostitution is legal in “tolerance zones.” But in Spain, prostitution is essentially legal, and the nation has become a magnet for sex trafficking. Can legalized prostitution ever be safe and free of exploitation? Or should laws against prostitution remain?

"Maryland’s highest court decided Friday that even though same-sex couples aren’t yet able to marry in the state, they do have the right to divorce.

"The Court of Appeals unanimously overturned the lower court, ruling that “a valid out-of-state same-sex marriage should be treated by Maryland courts as worthy of divorce.”

"The team of lawyers representing the women argued that Maryland has always recognized out-of-jurisdiction marriages — even in cases that are expressly illegal in the state, such as uncle-niece marriages. “We felt pretty confident that this case would be treated no differently,” Zavos said.

"The appellate court agreed, finding that the parties’ same-sex marriage is not “repugnant” to Maryland “public policy,” the bar it would have to reach for the couple to be legally turned away for a divorce. The seven judges didn’t miss the opportunity in the opinion to take a jab at the Maryland General Assembly, saying that to date, its treatment of same-sex relationships might “be characterized as a case of multiple personality disorder.”

"In March, Gov. Martin O’Malley (D) signed a bill legalizing same-sex marriage. The law is slated to take effect in January but faces a potential roadblock in November when a measure to repeal the legislation will appear on the ballot.

"Government funding of higher education as a percentage of GDP is highest in Finland, Norway and Denmark, but when private expenditure is added in, funding is highest in the United States, Korea, Canada and Chile. Investment in Research and Development is highest in Denmark, Sweden and Switzerland. The United States dominates the total output of research journal articles, but Sweden is the biggest producer of articles per head of population. The nations whose research has the greatest impact are Switzerland, the Netherlands, the United States, United Kingdom and Denmark. While the United States and United Kingdom have the world's top institutions in rankings, the depth of world class higher education institutions per head of population is best in Switzerland, Sweden, Israel and Denmark.

"The highest participation rates in higher education are in Korea, Finland, Greece, the United States, Canada and Slovenia. The countries with the largest proportion of workers with a higher level education are Russia, Canada, Israel, United States, Ukraine, Taiwan and Australia. Finland, Denmark, Singapore, Norway and Japan have the highest ratio of researchers in the economy.

"International students form the highest proportions of total student numbers in Australia, Singapore, Austria, United Kingdom and Switzerland. International research collaboration is most prominent in Indonesia, Switzerland, Hong Kong SAR, Denmark, Belgium and Austria. China, India, Japan and the United States rank in the bottom 25 percent of countries for international research collaboration. In all but eight countries at least 50 percent of students were female, the lowest being in India and Korea. In only five countries were there at least 50 percent female staff; the lowest being in Japan and Iran."

Thursday, May 17, 2012

A study of chemistry Ph.D. students in Britain reveals that academic careers start looking disproportionately unattractive to women compared to men as they progress through their studies. It appears that Ph.D. supervisors are largely to blame.

Here's a succinct summary: Why Women Leave Academia
"Young women scientists leave academia in far greater numbers than men for three reasons. During their time as Ph.D. candidates, large numbers of women conclude that (i) the characteristics of academic careers are unappealing, (ii) the impediments they will encounter are disproportionate, and (iii) the sacrifices they will have to make are great."

Executive Summary and Key Findings
This research attempted to establish what accounts for the findings of a RSC survey of the career intentions
of chemistry PhD students (RSC, 2008). It was a qualitative study which aimed to pin point the factors that
discourage women more than men from planning a career in research, especially in academia.

81 chemists, via eight focus groups (six with second year students, two with third year students) and 47 telephone interviews (23 with third year students and 24 with people who had recently completed a chemistry PhD programme) participated in the research.

The research identified that the following factors, which relate to the doctoral study experience, and deter a larger proportion of women than men from remaining in research beyond their PhD.

During doctoral study, a larger proportion of female than male participants had:

 Been deeply affected by what might be termed ‘standard supervision issues’ (e.g. enjoying little pastoral care and having to cope with a supervisor who lacks interpersonal/management skills); Encountered significant supervision issues, which they felt powerless to resolve;
 Experienced a lack of integration with their research group, isolation and exclusion (and more rarely,
bullying);
 Been uncomfortable with the culture of their research group (about working patterns, time and
expectations and the level of competition between group members), especially where the culture was
particularly ‘macho’;
 Developed concerns about poor (though normal) experimental success rates, apprehensive of what this may infer to others about their skills and competence;
 Formed the impression that the doctoral research process is an ordeal filled with frustration, pressure and stress, which a career in research would only prolong; rather than short-term pain for long-term gain.

The research suggested that where women do not wish to pursue an academic career, this is because they perceived the rewards on offer insufficient to overcome the challenge and compromise entailed.

In contrast to male participants, female participants had:

 Come to view academic careers as too all-consuming, too solitary and not sufficiently collaborative; Come to the conclusion that the short-term contract aspect of post-docing could not be reconciled with other aspects of their life, particularly relationships and family; Come to believe the competition for a permanent academic post was too fierce for them to compete successfully; Come to believe they would need to make sacrifices (about femininity and motherhood) in order to succeed in academia; Been advised in negative terms of the challenge they would face (by virtue of their gender).

The report concludes that the chemistry PhD programme and academic careers are modelled on masculine
ways of thinking and doing, which leaves women neither supported as PhD students nor enthused to remain in research in the longer term. Cultural as well as procedural change is required to address this.
********

In Economics, there are still fewer women full professors than men, although there are signs of change. Here's a story that takes note of the fact that three recent winners of the Clark medal are the mothers of young children... Women making gains in economics, but progress is slow